Janet Golden, professor of history, Rutgers University-Camden
How do you know that your water is safe to drink, your food safe to eat, and the medical tests performed by your doctor are giving accurate results? What standards do we use? Are they applied across the United States? What will we find when we travel abroad?
To find out, I talked recently with Dr. Leonard Freedman, founding president of the Global Biological Standards Institute. He has more than 30 years of research, management and program development experience in molecular and cell biology, biomedical research and drug discovery in both the private sector and academia. Before starting the institute, Dr. Freedman was vice dean for research and a professor of biochemistry and molecular biology at Jefferson Medical College in Philadelphia.
Following the World Health Organization's recent release of its report “Water Quality and Health Strategy, 2013-2020,” I was particularly interested in what standards mean for public health in the area of water and food safety.
Just when you thought our food supply was safe again.
In the wake of the government shutdown that suspended many of the essential protective services of the Food and Drug Administration and the U.S. Department of Agriculture (we wrote about this a few weeks back), an FDA report – released, appropriately, on Mischief Night – finds that the spices we season our foods with can be tainted with pathogens and filth.
A spicy meal, anyone?
“Tempeh Whiz wit'!” “Vegan cheesesteak!’’ Will these words soon be part of the cacophony of sizzling onion and clanking steel that echoes between Pat’s and Geno’s? Probably not, but recent activity in Philadelphia’s City Council indicates that this may not be as far off as you might imagine.
Well, OK, it's pretty far off. But it has reached the highest levels of government. Earlier this month, the City Council of Philadelphia unanimously approved a resolution in support of “Meatless Mondays.” The resolution, which is completely symbolic and includes no regulatory measures or spending, encourages residents and businesses across the City to curb carnivorous consumption on the first day of the work week. Simply put, the resolution is an attempt to raise awareness about healthy diet—a good thing from a public health perspective.
Councilman Bill Green (D-at large) was quoted in a press release from The Humane League stating: “I am happy to bring attention to this important issue. We can combat the epidemic of obesity, improve long-term health outcomes and potentially reduce the impact of livestock on global warming though this one, simple effort. And we can make our moms happy by eating our veggies and trying new things – a win-win-win!”
Teagan Keating, an MPH student at Drexel University
With a squeeze of lemon and a dash of hot sauce, raw oysters are a winter delicacy. Unfortunately, a recent letter in the New England Journal of Medicine warns, strains of Vibrio parahaemolyticus are contaminating some of them harvested from parts of the Atlantic Ocean.
What is Vibrio parahaemolyticus?
Vibrio is a group of bacteria that cause a variety of digestive issues. Other types of Vibrio cause severe illnesses such as cholera or blood infection. The bacteria noted in the letter, Vibrio parahaemolyticus, causes comparatively milder symptoms: diarrhea, vomiting, abdominal cramping, nausea, fever, and chills. Oysters and other shellfish become contaminated because V. parahaemolyticus naturally occurs in the waters where they live. These shellfish are the usual cause of the illness. Vibriosis can be especially dangerous for people with weakened immune systems but is rarely fatal for healthy people. The symptoms usually go away on their own within three days. (People taking antacids are more susceptible because stomach acid can help destroy bacteria, and antacids weaken the stomach acid.) The Centers for Disease Control and Prevention estimates there are around 4,500 cases of vibriosis caused by the species parahaemolyticus each year.
Janet Golden, professor of history, Rutgers University-Camden
The recent government shutdown brought a halt to most of the work of two agencies overseeing food safety. (Meat and poultry inspection continued under the auspices of the U.S. Department of Agriculture). The Food and Drug Administration (FDA), part of the Department of Health and Human Services, is responsible for protecting the public health by assuring the safety, effectiveness, quality, and security of human and veterinary drugs, vaccines and other biological products, medical devices, most of our nation’s food supply, all cosmetics, dietary supplements, and products that give off radiation and for regulating tobacco products. Outbreaks of food-borne illness are monitored by the Centers for Disease Control and Prevention (CDC). This is a critical public health task. As the CDC notes, in 2012, it monitored between 16 and 57 potential food poisoning clusters each week (emphasis mine).
While critics often rail about big government regulation, the fact is that laws providing for the safety of our food, drugs, cosmetics and medical devices resulted from public uproar following exposes and tragedies. Over the past century, Americans have demanded more regulation, not less. And the result has been to make us safer and healthier.
Government oversight of our food, drugs, cosmetics and medical devices came as the result of public insistence on cleanliness, safety, and honest labeling. Muckraking journalists, public health advocates and progressive women’s organizations together helped to secure passage of 1906 Pure Food and Drug Act that was signed into law by President Theodore Roosevelt. Many credit Upton Sinclair’s horrifyingly graphic novel about the stockyards, The Jungle, published in 1906, for prompting public outrage that persuaded lawmakers to take action. As a result of this law, meat inspection began, the manufacture, transport and sale of adulterated food products and poisonous patent medicines was forbidden, and habit-forming drugs (among them cocaine and heroin) were required to have accurate labeling.
Janet Golden and Michael Yudell
In his 1938 book, My America, Louis Adamic wrote about answering the doorbell one morning during the Great Depression to be confronted by hungry children on their way to school. A girl spoke to him:“ Excuse me, Mister…but we have no eats in our house and my mother said I should take my brother before we go to school and ring a doorbell in some house…and ask you to give us something to eat.”
The following year, after having distributed some surplus commodities, through the Federal Surplus Relief Corporation, the United States Department of Agriculture (USDA) created an experimental food stamp program that lasted until 1943. Food insecurity was a problem then and it is today. A recent report found that 22 percent of Philadelphians were food insecure, lacking enough food for an active, healthy life. Yet the nation is in the midst of a congressional debate about the Supplemental Nutrition Assistance Program (SNAP), the descendent of the 1964 Food Stamp Act. A Robert Wood Johnson Foundation study of the impact of the cuts that some in Congress proposed found they would lead to greater poverty and food insecurity, with as many as 1.2 million children losing eligibility for free or reduced price school meals.
Opponents of the SNAP program claim it suffers from problems of fraud. That is not true; the rate is low and falling. Others claim that too many are eligible for SNAP. That is the result of our current recession, which began in 2007. Some wonder what people buy with SNAP. The answer is food—but no food that will be eaten in the store and no hot food. You cannot buy alcohol or tobacco products with SNAP.
We write about a lot of complex issues here at The Public’s Health. Issues that seem intractable, such as implicit racial bias and poverty. Issues that are ethically challenging, such as organ donation. Issues that have serious implications for future generations, such as climate change and fracking. Such complexity is the domain of public health.
Some public health issues, however, are more straightforward. The relationship between cause and effect is clear, as are the preventive actions that can be taken. This Fourth of July weekend, we revisit one of these issues—swallowing the wire bristles of grill brushes.
On July 4th last year, we posted a story about the dangers of swallowing the bristles of wire brushes that are used to clean grills. The small, but exquisitely sharp, bristles come dislodged from the brushes, rest on the grill’s surface, cling to food, and are ingested—potentially causing serious lacerations in the mouth, throat, and stomach.
I just got back from 10 days in France. Like John Travolta in Pulp Fiction, I was struck by all the little differences in Europe—how the toilets work, the way roads are designed, and the size of a meal. Wherever I went, the portion sizes seemed much smaller than what I was accustomed to in Philadelphia.
While visiting the École des Hautes Études En Santé (French School of Public Health) in the city of Rennes, I actually met a researcher who had empirically investigated my observation—he had walked around Philadelphia and gone to restaurants, not to eat, but to weigh the content of the food he was served. His efforts contributed to an interesting study, published a decade ago in the journal Psychological Science, which explored whether portion sizes are indeed larger in Philly than in Paris.
First, the researchers compared the weight of identical meals (e.g., pizza, chicken sandwich) at comparable restaurants in the two cities. On average, they found that portions were 25 percent larger in Philadelphia than in Paris. (Their data suggest that the Royale with Cheese in Paris was actually the same size as a Quarter Pounder in Philly, but a “medium” fries was 72 percent bigger).